Addendum to the Supporting Statement - 0629

Addendum to the Supporting Statement for

Work Incentives Planning and Assistance (WIPA) Projects

OMB No. 0960-0629

Background

The Social Security Administration (SSA) funds the WIPA Training and Technical Assistance contract with administrative funds. In Fiscal Year (FY) 2018, SSA needed to reduce its use of administrative funds for the WIPA program. Rather than allow one contract to endure most of the cuts with severe effects, SSA made reductions to two contracts funded with administrative funds: (1) the Ticket Program Manager (TPM) contract; and (2) the WIPA Training and Technical Assistance contract. SSA will reduce the WIPA Training and Technical Assistance contract to only the essentials we need to provide training and technical assistance to the WIPA projects so we can continue to provide benefits planning services to beneficiaries. Training and technical assistance are a necessary support to the WIPA benefits planning services provided to beneficiaries and SSI recipients. We are reducing the WIPA Training and Technical Assistance contract by 1.6 million dollars by eliminating the Efforts to Outcomes (ETO) data system, and government-furnished laptops. SSA made a decision to make this cut, because the cost of ETO and the laptops are high relative to the total cost of the contract, being 32 percent of the total contract cost. We are removing the electronic versions of WIPA and replacing them with paper Forms SSA-4565 (WIPA Intake Information); SSA-4566 (WIPA Case Note); and SSA-4567 (Help Line WIPA Referral) to collect some of the information we collected previously in a different manner. We hope to reinstate the electronic versions once we have the funds to do so; however, we do not know when that will be.

Revisions to the Collection Instrument SSA-4565; SSA-4566; and SSA-4567

• Change #1: We are replacing the electronic versions of WIPA with the following SSA Forms:

SSA-4565 (WIPA Intake Information) - The WIPA project staff will use Form SSA-4565 to gather information about the beneficiary’s benefit status; employment history; status and goals; educational history; work incentive usage; and possible work incentive eligibility.

SSA-4566 (WIPA Case Note) -WIPA staff will use Form SSA-4566 to record services they provide.

SSA-4567 (Help Line WIPA Referral) – The Ticket to Work Help Line staff will use Form SSA-4567 with beneficiaries to the WIPA program serving their state. The form contains demographic information; information on the beneficiary’s Ticket status; benefit status; employment status; and questions about work and benefits state.

Justification #1: We are replacing the electronic versions of WIPA with Forms: SSA-4565;

SSA-4566 (WIPA Case Note); and SSA-4567 (Help Line WIPA Referral) so SSA can reduce its use of administrative funds for the WIPA program (see background section above).

This change will not affect the public reporting burden. We will implement this change upon OMB’s approval.